Awareness of the ability of severe emotional stress to provoke sudden death has been present throughout recorded history. However, the relationship of psychosocial factors to cardiovascular disease, and in particular sudden cardiac death, has been difficult to quantify. This has been due to several reasons:

●It is difficult to objectively quantify emotional stress

●Research has until recently been more focused on the chronic factors leading to the development of coronary artery disease rather than on the precipitation of acute coronary syndromes once such disease is present

●The division between the social science and medical science investigators have impeded dialogue

●There are inherent difficulties in accurately assessing the triggers of sudden death.

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